At MIT, specialists create ways to improve disease management

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“The problem is using the medicines,” said Dr. Sara Hamilton, a pediatrician at St.Mary’s Hospital and a researcher at University College London and Imperial College, all in London.

By Karen Weintraub
Globe Correspondent
January 30, 2012

At first, it was going to resemble an elephant’s trunk and reward kids with a funny trumpeting sound when they took their asthma medication. But group members eventually nixed that as too annoying and childish.

Then, it was going to resemble a ski ramp - but the downhill metaphor didn’t quite work.

Finally, the group settled on a horn-type shape, sounds chosen like ring tones, and a cartoon chameleon doing acrobatics when the child’s asthma is well controlled.

Such is the process of invention at the MIT Media Lab.

During the past two weeks, six teams of students, doctors, engineers, product designers, computer programmers, and entrepreneurs have been developing prototypes of inventions designed to help patients take control of their health.

It wasn’t quite “Iron Chef,’’ but there was a friendly competition, and a lot of tension about getting the work done in time to meet Friday afternoon’s deadline. Most teams worked through their one weekend and spent several late nights - or early mornings for those still on UK time - hacking away at their projects.

JONATHAN WIGGS/GLOBE STAFF

Ioannis Smanis (center) and his team designed a prototype inhaler-spacer-spirometer, specifically for children with asthma. Teams at the MIT Media Lab made devices to aid patients.

‘The problem is using the medicines.’

By Friday, the 11th day of the session, the teams had to deliver at least a semi-functional prototype and material for a video.

There was money at stake, too - an unrestricted $10,000 to be divided among the top three projects. At least early in the process, though, the desire for cash and bragging rights seemed to be outweighed by the more altruistic goal of developing technology to empower patients.

“My work is all about engaging patients so they can become experts in their care,’’ said Dr. John Moore, an MIT PhD candidate and the brains behind the Media Lab’s Health and Wellness Innovation 2012.

Patients often ignore their doctors orders, because they do not truly understand them, and doctors often do not understand a patient’s needs or the reasons they are not taking their medications.

“The problem is really the system and the tools, not necessarily the doctors and patients,’’ Moore said.

On Day 2, the teams met and began brainstorming ideas for their product. The asthma group was working on a combined inhaler and spacer - a device, like an empty bottle that kids need to add to their inhaler to make it effective.

David Rose, a Media Lab faculty member and chief executive of Vitality Inc., which develops smart medical packaging, was pushing for the trumpeting elephant trunk. He told the group he liked the concept of “putting a game on top of this, so the thing you’re seeing is the health of the elephant.’’

“I think the idea is rather than have it be about ‘me and my health,’ - I’m taking care of this other animal or avatar,’’ said Rose, a Brookline resident and father of two. Maybe the trunk could be striped or polka-dotted, and “if you don’t take your inhalant it loses its spots.’’

Lauren Lyons, a student at the Harvard Kennedy School of Government and former product engineer, wanted some clarification. “Can we just flesh out?’’ she asked the group. “If there was one thing we could accomplish throughout this whole 10 days, what would that be?’’

A few days later, with Rose on a business trip to California, the idea had evolved away from the trunk, though the team was eager to preserve the fun element. Sucking multiple times daily from an inhaler is boring business, Dr. Sara Hamilton told the group, so they needed to give kids an incentive to keep it up.

“Asthma is a preventable, controllable illness if you’re on top of it,’’ said Hamilton, a pediatrician at St. Mary’s Hospital and a researcher at University College London and Imperial College, all in London. Properly controlled, the disease needn’t lead to hospitalizations, she said.

And yet many children can’t stick to the daily regimen or cope with environmental stresses like allergies, colds, and sports activities - that’s what the device should help them do.

“We don’t need new molecular advances in the medicines,’’ for asthma, Hamilton said. “The problem is using the medicines.’’

Patients will comply with a doctor’s orders when it is easy for them to do so and when they understand why they should, she said.

That idea was a driving force behind the other groups, as well, including one designing a health goals app for patients.

The team wanted to make a program that would allow patients to pick a goal that mattered to them - say, having the energy to play with their grandchildren or get to church on Sunday - and then map out a health plan that would get them there, including exercise, nutrition, and a medication regimen. Doctors and family members would have access to the goals, so they could help the patient achieve them.

Two team members, who work at the center for innovation and complex care at Toronto General Hospital, said they were eager to try out the program on their patients.

“Maybe if they understood what a beta blocker did, they might be more willing to take it,’’ said Christine Plaza, a designer and project manager for the center. Or maybe patients would do a better job of avoiding cigarettes if someone explained that smoking makes it harder for surgical sites to heal, she said.

Plaza and colleague Dr. Seema Marwaha, working Tuesday morning on their project video, said they love the concept of a computer program that helps caregivers really understand what the patient wants.

“Executing the concept is another thing,’’ Marwaha said, laughing.

Back at the asthma team, after lots of painstaking, late-night work, Ioannis Smanis, a hardware developer and student at the University of Macedonia, had managed to program a skeletal prototype. While a 3-D printer printed out a tube to put it in, he tinkered with electronics that could react to a child’s breath, sense when a breathing problem was beginning, light up if a child missed a medication dose, and reward the youngster for a week of successful medicating with - at that point, still dreadful - noises and the antics of a cartoon chameleon.

On Friday, asthma team members felt triumphant, their success confirmed by a first-place finish in the competition. “I think we have all the pieces to really change childhood asthma, albeit in draft form,’’ Rose said.

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